Opioid use disorder is a significant public health problem in all 50 states. While various organizations, such as state health agencies, public health organizations and academia have developed tracking and analytics mech- anisms for this epidemic, current approaches typically have two major limitations: (1) limited geographic cover- age and (2) time-delayed data that only cover late stages of opioid use disorder, such as overdose and death data. A key challenge of the opioid epidemic is to aggregate and analyze relevant data from various sources over large geographic areas in order to uncover leading trends early enough to be able to intervene effectively and efficiently. This project proposes creating and evaluating a nationwide, live and dynamic opioid analytics dashboard for the United States. The main source for this dashboard is a continuously growing laboratory re- sults database currently comprised of over 4 billion records from 100s of US clinical/laboratory sites, dating back to 2013. This data set contains opioid-related test results from both legal, such as medically prescribed, as well as illicit use of drugs. In Specific Aim 1, we will create a live, nationwide opioid analytics dashboard for the United States using a user-centered design strategy. This aim will build on our preliminary work of having built and licensed state-focused dashboards for Tennessee and Indiana. Through several focus groups, we will first define local, regional and national use cases for additional analyses and visualizations in collaboration with public health, healthcare provider and pharmaceutical organizations. Subsequently, we will implement addi- tional decision-focused functionality and scale up the opioid analytics dashboard to all 50 states. In Specific Aim 2, we will conduct formative evaluation and preliminary validation of the dashboard. The formative evalua- tion will consist of heuristic evaluation, cognitive walk-through and usability testing. For the preliminary valida- tion, we have partnered with the Marion County Public Health Department (MCPHD) and the Regenstrief Insti- tute Data Core to conduct a series of analyses that will compare hc1.com's data and analytics results with data about patient demographics, toxicology results, trends over time and other variables in the Indiana Network for Patient Care, and overdose ambulance runs, opioid-related ED visits and OD deaths from the MCPHD. Our project is significant because the opioid epidemic is a severe and rapidly developing problem at the local, re- gional and national level. To cope with this epidemic, we must synthesize and analyze relevant data that are (1) fragmented across a variety of settings; (2) siloed in different data repositories and formats; (3) difficult to interpret and navigate; and (4) complex to aggregate due to the lack of adherence to naming conventions or standards. Our project is highly innovative because it will (1) produce a nationwide, live and dynamic opioid analytics dashboard - which currently does not exist - and (2) use data that are generated much earlier in an individual's journey into opioid use disorder than most current metrics of the epidemic. Thus, our system pro- vides significantly greater opportunities for monitoring, prevention, and intervention than current approaches.